MEDICARE: QUALITY MEDICAL ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1437266293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY MEDICAL ASSOCIATES PC

Provider Business Mailing Address
First Line	:	11129 QUEENS BLVD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5553
Country	:	US
Telephone Number	:	718-275-8900
Fax Number	:	718-785-0430

Provider Business Practice Location Address
First Line	:	11129 QUEENS BLVD
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5553
Country	:	US
Telephone Number	:	718-275-8900
Fax Number	:	718-785-0430

Authorized Official
Title or Position	:	OWNER OPERATOR
Name	:	DR. NODAR KOZHIN
Credential	:	MD
Telephone Number	:	718-275-8900

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	08/22/2020

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